My long-term goal is to apply rigorous patient-centered outcomes research methodologies to improve the quality and safety of patient care in the intensive care unit and perioperative setting. I have served as principal or co-investigator on more than a dozen funded awards to develop, implement and evaluate comparative effectiveness research focused on improving quality and safety of patient care. Despite this extensive experience, none of my research has had significant patient or family involvement. The proposed career enhancement program will allow me to gain the additional skills and experience required to conduct high quality patient-centered outcomes research and provide a foundation for a successful career as an independent patient-centered outcomes researcher. My career enhancement plan includes: 1) formal coursework in patient-centered outcomes research, 2) conferences and seminars focused on patient-centered outcomes research, 3) participation in PCORI funded research projects, and 4) structured mentoring by a senior investigator and a well-qualified advisory committee for the conduct of research that is responsive to and involves patients and families throughout the research process. The objective of the proposed research is to partner with patients and families to improve care for mechanically ventilated patients by improving provider communication with patients and families regarding the use of mechanical ventilation, potential complications and strategies to reduce them, and empowering families to take an active role in related care. The specific aims are to: 1) Engage a council of patient and family partners to identify current knowledge and key experiences of mechanical ventilation, complications they value, key content to communicate, and individual- centered approaches to communication. 2) Partner with the patient and family council to develop a patient and family-centered ventilator toolkit to improve communication of providers regarding mechanical ventilation, and to empower families to take an active role in the care of a mechanically ventilated patient. The new toolkit will be broadly disseminated to providers, patients and families in ICUs through an extensive professional network and provide a framework that may likely be applied in other areas of preventable harm. The proposed research is novel in the critical care field and fills a gap in efforts to improve care and reduce complications associated with mechanical ventilation. Successful completion of the proposed research will advance patient-centered outcomes research by generating new knowledge in the area of critical care, partnering with patients and families to increase adherence with evidence-based recommendations and improve care for mechanically ventilated patients, and engaging patients and families in ICU care.